Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.24 / $66.12 / $94.34	Facility	26	$59.24	$66.12	$94.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $119.57 / $151.90 / $467.20	Professional		$119.57	$151.90	$467.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.92 / $85.66 / $678.24	Professional	26	$56.92	$85.66	$678.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $60.34 / $60.34 / $136.79	Professional	TC	$60.34	$60.34	$136.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $98.20 / $98.20 / $161.41	Professional		$98.20	$98.20	$161.41
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $45.54 / $76.38 / $109.64	Professional	26	$45.54	$76.38	$109.64
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $85.53 / $126.38 / $163.08	Professional	26	$85.53	$126.38	$163.08
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $122.18 / $204.18 / $242.35	Professional	TC	$122.18	$204.18	$242.35
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.78 / $68.78 / $68.78	Facility	26	$68.78	$68.78	$68.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $161.75 / $239.55 / $371.13	Professional		$161.75	$239.55	$371.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.71 / $97.41 / $162.85	Professional	26	$62.71	$97.41	$162.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $88.09 / $135.99 / $212.01	Professional	TC	$88.09	$135.99	$212.01
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $89.49 / $120.00 / $187.50	Facility	26	$89.49	$120.00	$187.50
Medcost Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $89.00 / $164.00	Professional		$75.00	$89.00	$164.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $89.49 / $89.49 / $89.49	Professional	26	$89.49	$89.49	$89.49
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $82.91 / $97.38 / $312.70	Professional		$82.91	$97.38	$312.70
United Facility/Professional Professional Modifier Low / Median / High Price $134.56 / $204.66 / $345.60	Professional		$134.56	$204.66	$345.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.99 / $91.39 / $163.96	Professional	26	$60.99	$91.39	$163.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $74.03 / $120.78 / $185.68	Professional	TC	$74.03	$120.78	$185.68
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $141.46 / $174.25 / $347.58	Facility	26	$141.46	$174.25	$347.58
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,067.26 / $1,067.26 / $1,067.26	Professional		$1,067.26	$1,067.26	$1,067.26
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $716.57 / $855.01 / $855.01	Professional	26	$716.57	$855.01	$855.01
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $746.61 / $746.61 / $746.61	Professional	TC	$746.61	$746.61	$746.61